increase in nurse turnover
A nursing shortage has been shown to decrease patients access to care, decrease job satisfaction, and increase nurse turnover (Huber, 2010). “The current nursing shortage is anticipated to become twice as large as any nursing shortage experienced since the 1960s” (O’Neil, 2009, p. 180, para 7). Nurse shortage has been a significant focus of study and debate because of the enormous effect it has on all of us at every possible level of healthcare. Numerous research studies have been conducted to determine the main factors driving the nursing shortage. “This shortage is not solely nursing’s issue and requires a collaborative effort among nursing leaders in practice and education, health care executives, government, and the media” (Nevidjon & Erickson, 2001). Factors contributing to the nursing shortage include the following: Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services, nursing school faculty shortage is restricting nursing program enrollments, a significant percentage of the current nursing workforce is nearing retirement age, there is an increased need for nursing care because of our aging population, and insufficient staffing is intensifying nurses’ stress level which impacts job satisfaction and drives many nurses to leave the profession.
Although there has been a 3.6% increase in baccalaureate nursing program enrollment in 2016 according to the AACN (2017), this increase is not even close to sufficient enough to meet the projected demand for nursing faculty, researchers and primary care providers. The AACN also reports that nursing schools in the U.S. turned away 64,067 qualified applicants in 2016 due to an insufficient number of faculty, clinical sites, clinical preceptors and budget limitations. Nevidjon & Erickson discuss multiple collaborative recruitment efforts happening currently:
In San Diego, six hospital systems have committed $1.3 million to support a program called, “Nurses Now”, which will add faculty and additional student slots to San Diego University. The American Hospital Association News reports that in Laredo, Texas, a hospital CEO worked with Texas A&M University to develop a four-year bachelor’s program and is providing $425,000 in scholarships to local students over the next five years. In Morris County, New Jersey, the Board of Freeholders offered scholarships to students who agreed to work in a long term care facility. The Dallas-Fort Worth Hospital Council raised $600,000 to expand student enrollment at local schools. These are examples of various successful collaborative efforts among healthcare organizations, government, nursing associations and nursing schools. Many more are happening at the local level (2011).
Ineffective leadership and management continue to foster suboptimal work environments minimizing the rate of improvement in the nurse shortage and turnover rates. According to Kleinman (2004), results from a study conducted by Volk and Lucas in 1991 revealed that “management style was the only predictor of anticipated turnover” (p. 129, para 4). This correlation further substantiates the amount of influence that nurse leaders have on healthcare organizations in a variety of ways including: decreased quality of care, loss of patients, increased nurse turnover, increased turnover of medical support staff, increased staffing costs, and increased accident and absenteeism rates (Hunt, 2009). Work environment has also been cited as a significant predictor of nurse turnover. Nurse autonomy, interactions with managers, compensation and workload are all factors that have been reported to facilitate job satisfaction or lack-there-of, ultimately determining staff retention and turnover (Huber, 2010). Leaders need to be aware of and understand the current healthcare challenges and develop expertise in the skills and approaches requisite for effective leadership (O’Neill, 2013). “People’s time and effort, as well as organizations’ money, facilities, and supplies, need to be directed in a coordinated effort to achieve best results and meet objectives” (Huber, 2010).
Over time, study results have been consistently indicative of the direct impact managers and leaders have on the quality of healthcare at every level. The importance of highly qualified and effective nurse leaders is evident now more than ever and by improving the methods used to manage nurses, positive changes will be put into motion (Hunt, 2009). While the direct benefit would be decreasing the nurse shortage, this change would also significantly benefit the availability and quality of healthcare for everyone. Implementing enhanced methods of managing nurses would successfully result in improved staffing. In fact, effective leadership and management may be the key to overcoming the nurse shortage and finally optimizing the quality of healthcare for all.
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